Human growth hormone (hGH) is a 191-amino acid, single-chain polypeptide hormone released from the anterior pituitary gland under the control of the hypothalamus.  In children, growth hormone (GH) has growth-promoting effects on the body.  It stimulates the secretion of somatomedins from the liver, which are a family of insulin-like growth factor (IGF) hormones.  These, along with GH and thyroid hormone, stimulate linear skeletal growth in children.  In adults, GH stimulates protein synthesis in muscle and the release of fatty acids from adipose tissue (anabolic effects).  It inhibits uptake of glucose by muscle tissue while stimulating uptake of amino acids.  The amino acids are used in the synthesis of proteins, and the muscle shifts to using fatty acids as a source of energy.  GH secretion occurs in a pulsatile (short, concentrated) secretion at night during deep sleep.  Thus, people suffering from sleep apnea, insomnia, or other sleep disorders may have lower than optimal levels of hGH.

Declines in hGH secretion are seen in people with histories of traumatic brain injury (any head injury that caused a loss of consciousness), sleep problems, chronic illness, and the aging process.  Repetitive head trauma, as seen in contact sports, has been shown to cause dysfunction of an area of the brain called the hypothalamus.  This area of the brain controls the regulation of many hormones, including hGH.  Two popular theories for the decline of hGH over time exist.  One explanation is that as the pituitary ages, it loses its ability to secrete hGH.  The other theory is that stress, illness and aging cause an increase in the release of somatostatin.  Somatostatin is a hormone released in the brain to inhibit or stop the release of hGH.

Reported effects on GH deficient patients include decreased body fat, increased muscle mass, increased bone density, increased energy levels, improved skin tone and texture, increased sexual function, improved sleep, improved heart and lung function, and improved immune system function.  At this time, hGH is still considered a very complex hormone, and many of its functions are still unknown.  hGH has been used for remission of multiple sclerosis, to reverse the effects of aging in older adults, to enhance weight loss in obesity, as well as fibromyalgia, heart failure, Crohn’s disease and Ulcerative colitis, burns and bodybuilding or athletic enhancement.

Side effects, such as joint swelling, joint pain, carpal tunnel syndrome, an increased risk of diabetes and decreased thyroid functions have been reported.  These are usually related to supraphysiologic doses (higher than optimal levels).  Long-term use of these high doses can also lead to acromegaly (thickening the bones of the jaw, fingers and toes), or gigantism.  These are very serious conditions that, fortunately, are all but eliminated with proper physician supervision.

Frequently, patients are concerned with the risk of cancer and the use of hGH.  Our bodies produce millions of new cells each and every day.  With these vast numbers of production there is bound to be some abnormal cell production.  Our immune system is responsible for finding and destroying these abnormal cells.  As stated earlier, the immune system is enhanced by hGH, and therefore performs its function better, and thus reducing the likelihood that these abnormal cells will go on to produce a cancer.  The data from cancer survivors have consistently shown no increased risk of recurrence of the primary tumor in survivors of all tumor types who are treated with hGH.  Overall, the clinical data is reassuring, but continued surveillance is mandatory.

There are now more ways to improve natural hGH levels in the body besides direct administration of the hormone.  Doctors have prescribed growth hormone releasing hormone (GHRH) to stimulate the pituitary release of hGH.  Traditionally, this had been used to test for growth hormone deficiency, but now it is used therapeutically as well.

There is also research regarding finding ways to increase the body’s own natural production of hGH through the use of secretagogues.  They work one of two ways, by directly stimulating the pituitary gland to secrete more hGH, and/or by inhibition of somatostatin.  Unfortunately, there are a lot of products without research that are of no value.  However, after recent review and evaluation, I believe that there is a relatively new product that has demonstrated clinically effective positive impact on the body’s ability to increase its own natural hGH production.  This product is believed to work by binding with those specific receptors that cause the desired secretion of the releasing factors that are ultimately responsible for hGH production.  It is a sublingual product with a patented receptor cell targeting liposomal delivery, designed to stimulate the pituitary.  It is made of naturally occurring secretagogues.  It comes in a spray that is directed under the tongue twice a day, with the cost being about one-eighth of injectable hGH.

It is extremely important for anyone wishing to explore the possibility of hGH use to seek medical advice from a physician.  Laboratory tests, history and physical examination all play a critical role in the determination of human growth hormone deficiency.  When optimal levels of hormones exist, and one blindly ventures into the use of hGH, the risks for negative side effects increases.  Some of these side effects are irreversible and very dangerous.

Dr. John J. Pierce • Ageless Forever Anti-Aging and Longevity Clinic is located at 6020 S. Rainbow Blvd. Suite C  Las Vegas, NV 89118 • 702-838-1994 •



OMG!...I have Bitch Tits!

By Frank Monaco

Bitch-Tits, (aka Gyno, Man Boobs, Moobs or the more appropriately called gynecomastia) is a subject often discussed among athletes in the bodybuilding and fitness communities. For the rest of us, “gyno” is an issue that causes insecurity and discomfort and is, therefore, a closely kept secret. Most men aren’t aware of how prevalent an issue  gynecomastia is. You might be surprised to learn that one in four men have some degree of gynecomastia. Men can feel insecure or ashamed of their bodies due to this enlargement of breast tissue that causes their chest to have a feminine appearance. If this describes you or someone you may know, there’s a procedure that can remedy this affliction. 

Dr. Frank Stile, an accomplished cosmetic plastic surgeon in Las Vegas, NV, is one of the most experienced gynecomastia surgeons in the country.  His patients include professional athletes, UFC fighters, boxers, Mr. Olympia competitors and regular guys.

What is Gynecomastia?

Gynecomastia is commonly referred to as “gyno” or “bitch-tits.”  It is the result of enlarged or swollen breast tissue (gland) in men, commonly caused by an imbalance in the male hormone testosterone and the female hormone estrogen.  Gynecomastia isn’t typically dangerous, but it can cause mild pain and discomfort.  Disproportionately increased fat localized to the chest can also cause the appearance of gynecomastia or worsen the appearance of gynecomastia resulting from an enlarged gland. 

Regardless of the cause, affected men universally complain, “it just doesn’t look good.” The most common issue for men/boys with gynecomastia is lowered self-esteem resulting from this enlarged breast tissue. In many cases, patients may be so sensitive about their appearance that they refrain from events or situations in which they have to remove their shirt. These feelings of insecurity are heightened in gym locker-rooms, public pools, the beach when wearing form-fitting shirts and even in intimate encounters.

Gynecomastia surgery is on the rise.

There is an increased awareness of gynecomastia in both the general public and plastic surgery community. This has made it less of a taboo subject for discussion and more “main stream.” In 2011, 19,766 cases of gynecomastia corrective procedures were performed as reported by the American Society of Plastic Surgeons (ASPS)— an 8% rise from 2010.  

In 2015, The ASPS showed that men accounted for more than 40% of breast reduction surgeries performed in the U.S. A total of 27,456 breast reduction surgeries (gynecomastia corrective procedures) were performed on men, representing a 5 percent increase over the previous year and a 35 percent increase since 2000.


A before and after of one of Dr. Stile’s actual gynecomastia patients - click here to see more


What Causes Gynecomastia?

Gynecomastia is caused by an altered ratio of androgens to estrogens resulting in increased estrogen levels. Estrogen acts to increase the size of male breast tissue and is made to appear worse by excess fatty tissue in the breast. The cause of gynecomastia is unknown in the majority of cases, but drug use (pharmaceutical and illicit) are estimated to be the main contributor and cause up to 25% of cases of gynecomastia.

Certain health problems in men such as malnutrition, liver disease, kidney failure or low testosterone production can cause breast growth in men. Drugs and liver disease are the most common causes in adults.

Some of the common medications that are known to cause gynecomastia include:  

Ketoconazole, cimetidine, gonadotropin-releasing hormone analogues, human  growth hormone (HGH), human chorionic gonadotropin (hCG), finasteride, estrogens, and antiandrogens, flutamide, and spironolactone, calcium channel blockers such as verapamil, amlodipine, and nifedipine; risperidone, anabolic steroids, alcohol, marijuana, opioids, and omeprazole— just to name a few.

Anabolic steroid (androgen) use is a very common cause of gyno in the fitness and bodybuilding community.  When patients take anabolic steroids, their body temporarily ceases production of testosterone. This is sometimes called suppression.  When patients abruptly stop using these androgens, it takes a while for their body to produce normal levels of testosterone again.  This lag-time creates an imbalance with more estrogen being produced. The higher levels of estrogen can cause the breast gland to grow, resulting in gynecomastia.


A before and after of one of Dr. Stile’s actual gynecomastia patients - click here to see more

How does Dr. Stile Treat Gynecomastia?

Picking the right surgeon to correct your gynecomastia is extremely important. Incorrectly performed procedures can leave patients with noticeable deformities. Many of Dr. Stile’s patients are professional athletes who regularly appear on TV. These athletes can have their reputations adversely affected by the negative associations made between gynecomastia with performance enhancing drug (PED) use. These often incorrect assumptions can be career ending.

Treatment of gynecomastia begins with a thorough history and physical examination of the patient. Important aspects of the physical examination include evaluation of the male breast tissue to evaluate the cause of gynecomastia being fat vs. gland or both.

This is followed by a genital exam and evaluation of testicular development  and an assessment for masses that may raise suspicion for testicular cancer. Younger patients are assessed for proper development of secondary sexual characteristics, such as the amount and distribution of pubic and underarm hair. Gynecomastia usually involves both breasts but may occur unilaterally (one side) as well. 

A careful review of the medications or illegal substances patients take may reveal the root cause of gynecomastia.  In addition, blood work is also performed to find the underlying cause of gynecomastia. Lab tests include liver function tests, renal (kidney) function tests and thyroid levels. 

Sex hormones such as Serum beta-human chorionic gonadotropin (B-Hcg), Serum testosterone levels (free and total), estradiol, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) may also be evaluated to determine if hypogonadism (under-developed testes) may be the cause of gynecomastia. 

Just like many other conditions, there are different ways in which gynecomastia can be present in males.  True gynecomastia is generally characterized by enlarged glandular tissue whereas pseudo-gynecomastia presents with excess adipose (fatty) tissue.  Most cases are a combination of both. There may also be varying amounts of excess skin present that may need to be addressed during corrective surgery.

The severity of Gynecomastia is graded as follows:

•  Grade I: Minor enlargement, no skin excess

•  Grade II: Moderate enlargement, no skin excess

•  Grade III: Moderate enlargement, skin excess

•  Grade IV: Marked enlargement, skin excess

The choice of a specific treatment to correct this disorder depending on the severity of gynecomastia.

Dr. Stile, a world-renowned board certified cosmetic plastic surgeon, uses an excision of the breast gland in the case of enlarged glandular tissue and liposuction for cases with excess fatty tissue.  Some patients require both gland excision with liposuction contouring to achieve the best result. 

Most commonly the incision is in the lower part of the areola, and each incision is usually no bigger than two centimeters for most patients.  For extreme cases, Dr. Stile will use a male breast lift technique, removing excess skin to achieve optimum, most masculine results for his patients. Most procedures take approximately 90 minutes, but some extreme cases can require three hours of surgery time. Discomfort following this procedure is minimal. Most patients can return to full normal activity at about two weeks after surgery, including exercise.

Where is this surgery performed?

Dr. Stile is the only cosmetic plastic surgeon in Las Vegas who will perform your surgery in his private surgery center.  His facility, Premium Surgical Services Center, is the only dual state and federal certified ambulatory surgical services center in Southern Nevada. This center was designed with only one goal: to provide the highest quality care, comfort, and privacy for all of Dr. Stile’s patients. 

Want to learn more on how you can overcome this disorder?

If you’re interested in scheduling a complimentary gynecomastia consultation, either in-person or via e-mail and phone, contact us via (725) 222-8644 or visit us on the web at 

HEALTH - 0317

0317 health mosaic


By Dr. John J. Pierce, DO COEP, Aabaarm

Laser Therapy for Hair Growth

Hair-loss is a real concern for many.  Alopecia is the clinical term for it, and it affects up to 70% of men and 40% of women.  Fortunately, science and medical professionals have found alternatives to the not-so-hot hair plugs and invasiveness of hair transplants.  Laser therapy, used to combat the loss of hair, has been consistently rising in popularity.

In the teen years, our full head of hair produces healthy, thick hair follicles.  Over time, due to hormonal changes and environmental factors, these same follicles begin to get thinner and maybe even wither away.  By using low-level laser therapy, the same shaft of hair can be stimulated in a non-chemical and noninvasive way.  The light energy is converted at the follicle and begins to stimulate cellular metabolism.   

Many laser devices have come out touting their effectiveness in treating hair loss.  What started as an in-office treatment has now turned into a home therapy device that patients can operate themselves.  The method I recommend to my patients is the Capillus 272.  It’s a cap with 272 medical grade laser diodes, giving their follicles maximum stimulation for hair growth.  Hair growth laser therapy can both decrease the rate at which patients are losing hair and regrow hair that has been lost.  It increases the blood flow in the skin to the hair follicle and sends oxygenation to the base of the follicle.  They will use the laser light therapy cap and wear it for 30 minutes every other day.  It’s a simple easy-to-use hands-free device that makes operating it a breeze.  The pain-free procedure is FDA approved and clinically proven.

Be sure to not confuse the Capillus 272 with other cheaper laser hair growth devices on the market such as the laser comb.  The cap stays on your head with constant exposure during the half an hour you wear it making the laser diodes more efficient in increasing the hair growth rate. The design of the device is also very convenient.  You can put it under any baseball cap, or hat and wear it while you are taking your dog for a walk or whatever task you might need to accomplish.

It’s also important to remember when embarking on any hair growth treatment that it can take up to 6 months to see real results in your therapy.  I recommend our patients take progressive photos during the treatment; small progressions can sometimes be harder to see, so it’s important to document the journey.  In addition to using the laser therapy, a patient can also combine it with top prescription hair loss medicines like Rogaine or Propecia.  Talk to your doctor about other reasons why your hair may be thinning other than just chalking it up to genetics.  Thyroid problems, Low-T, and hormonal imbalances may lend a hand to what’s making you lose your hair.  Let your physician guide you during your treatments for maximum results.




By Dr. John J. Pierce, DO ACOEP, ABAARM




When you think of a medical concierge, a private personal doctor tuned into your needs, images of the super-rich pop into your head.  With the passage of the affordable care act affectionately known as Obama-care, the rise of medical concierge services has increased and become a common way for middle-income patients to get their healthcare.  Patients pay either a monthly fee or an annual one to the doctor to get this service.  It has become a trend for many to reduce their primary care coverage to catastrophic coverage, and opt for paying for a medical concierge for their care.

There are many benefits to switching to this service which is quickly gaining in popularity.  In the traditional health care system, most of the time clients only visit their Doctor when they feel sick.  The doctor looks at the patient with little knowledge of their medical history and orders tests and prescribes medicines that may be unnecessary or potentially harmful.  With a medical concierge, the patient has routine checkups with their doctor in which the physician draws their blood, does a physical, and then meets with the patient to analyze the results.  The doctor then can make preventative recommendations such as a vitamin regimen, nutritional counseling, and more.  By treating the body before it becomes stricken with any form of illness, and monitoring the patients’ health, it results in less spending on the patient’s part.  The British Journal of Medicine recently studied a direct care facility and found positive results for the patients.  It discovered that the patients experienced “35% fewer hospitalizations, 65% fewer specialist visits, and 82% fewer surgeries than similar populations.”

There is also the personal aspect of signing up for a medical concierge service.  On their routine visits to the office, most doctors also perform routine mental assessments of the patient to make sure there are not any signs of potential mental health issues.  In addition to this, the doctor makes themselves and their staffs available 24/7 and or same day, next day service to their clients.  You can call them with any concerns and speak with someone about them.  It’s a holistic approach to treating a patient with a high level of care.  And when you do visit your doctor you get quality time with them.  Most concierge physicians spend up to 30 minutes with each patient and offer next day or even same day appointments.

Doctors that opt to become medical concierges are bucking the traditional healthcare system and dedicating themselves to better patient care.  They are loosening the shackles of a third party pay system and no longer beholding to insurance companies, and Medicare alike.  Many are estimating that this trend will continue to gain favor, and more and more patients and doctors alike will be switching to this model.  It makes care for both patient and doctor more fine-tuned, productive, and rewarding for them both.





By Dr. John J. Pierce, DO ACOEP, ABAARM


Some people call them “lines of distinction.” Others look in the mirror and see wrinkles as a professional hindrance, giving a false impression to the world as someone much older than they feel and their actual age. 

Vegas, especially—is a town where youth is celebrated in the workplace, and an ageless appearance is a strong asset in the business world. And you didn’t get those lines by just sitting around, relaxing on the job. It’s when we are at our peak in concentration that we tend to create those very wrinkles. Luckily, there are solutions to smooth those animated lines on your face—without surgery.  

Dysport is a non-surgical wrinkle treatment formulation that is used to address the need to reduce and smooth away wrinkles and frown lines. The prescription injection is extracted from Clostridium botulinum, (the same medication used for Botox) and exerts its action by temporarily immobilizing the muscles that are directly under your facial lines and wrinkles.  

The result? You still look like you — just smoother.

It’s the concentration/frown lines that are minimized with Dysport—not your expressions. Both Dysport and Botox therapy deliver phenomenal results, revealing a more youthful look, without having to undergo surgery. The simple non-invasive injection turns back the hands of time and significantly reduces the appearance of fine lines and wrinkles, creating an ageless image that can take years off your appearance—and is easily maintained. More than half of the patients see improvement in just 2-to-3 days, with 97% of the patients saying they’d do it again. And the results obtained using Dysport are also long-lasting, usually at an average of three to four months.

As an age management clinic specializing in providing only the best state-of-the-art cosmetic technology, my staff and I at Ageless Forever Anti-Aging Clinic in Las Vegas are able to provide patients with effective and reliable medical therapy to protect their health during the progression of the aging process. We provide a large variety of anti-aging techniques, including the careful use of Dysport therapy, which we prefer to use for men, and Botox therapy for women. Both genders gladly utilize the youthful transformation as one of their many “tools” of the trade in business.

Dr. John J. Pierce, D.O. • Ageless Forever Anti-Aging and Longevity Clinic located at
6020 S. Rainbow Blvd. Suite C Las Vegas, NV 89118 • 702-838-1994 •



A new study from the University of Eastern Finland suggests that simply by looking into the retina of the eye, doctors will be able to identify diseases of our central nervous systems, making a more efficient and less invasive method to diagnose brain diseases. For Huntington’s disease, changes in day and color vision showed as presymptomatic of the disease, while night vision abnormalities were found correlated with Alzheimer’s disease. The findings show greater evidence that changes in the retina may be linked to the central nervous system, and that the fastest progressive symptom was visual impairment. 

Both Alzheimer’s and Parkinson’s are difficult diseases to diagnose until symptoms have begun to appear. Now researchers have found that through routine eye tests, they can detect changes in the retina, which would allow for much earlier diagnosis and treatment of Parkinson’s disease before symptoms might even appear. After researchers confirmed retinal ganglion cell changes and alterations in thickness of the retina in the rats that had been induced with a form of Parkinson’s, they found that treating them with the anti-diabetes drug, rosiglitazone (Avandia), actually reduced the death of the retinal cells and that the drug may have a protective effect on the brain, suggesting a possible preventative breakthrough in one of the worlds’ most debilitating diseases.

The University of Georgia is competitive both on and off the field, taking first place on this year’s “2016 Trojan Sexual Health Report Card,” an annual ranking from Trojan Brand Condoms for committing to sexual health on campus. U of G was awarded the #1 position because of their strong support system for not just practicing safe sex, but their on-campus sexual health resources, like their Condom Express program, which makes condoms conveniently accessible across the university grounds; their Project Condom Exhibition, which gives students the creativity to design their own line of condoms for a condom fashion show; and of course, their commitment to HIV/STI testing. The condom manufacturer has seen nothing but positive impact for a decade now since they their first report in 2006, noting U of G vastly improved their on-campus sexual health resources since their #15 ranking in 2014. Trojan continues to encourage college students for their active interest in sexual health, and will be donating over 100,000 condoms to schools throughout the country in 2016.

For heightened orgasms and better control during sex, and even delaying ejaculation, all you have to do is a little workout. Not in the gym, but anywhere when you’re just sitting in a relaxed atmosphere. To locate your kegel or pelvic muscles, try stopping your flow when urinating. Another way to locate the muscles on your pelvic floor is to squeeze as though trying to hold back passing gas. Kegel muscles connect to the base of your penis. By tightening and holding for a few seconds, then relaxing, your muscles will be strengthened for even better performance and experience in the bedroom.

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